Tuberculosis (TB)

WHO treatment guidelines for rifampicin- and multidrug-resistant tuberculosis, 2018 update

Guideline Development Group (GDG) meeting - 16 to 20 July 2018

About 600,000 new cases of rifampicin-resistant or multidrug-resistant tuberculosis (MDR/RR-TB) are estimated to emerge each year, requiring treatment with second-line TB treatment regimens. Recent improvements in diagnostics and treatment have led to an increased detection and improved cure rates among MDR/RR-TB patients in several settings. However these successes have not been reproduced in much of the world and many MDR/RR-TB patients do not receive safe, effective treatment.

For over 20 years WHO has produced treatment guidance for drug-resistant TB to help countries address these challenges. The latest evidence-based guidance for the treatment of MDR/RR-TB was published by WHO in October 2016, in accordance with the requirements of the WHO Guideline Review Committee (GRC) using the GRADE system for evidence assessment. Since these guidelines were released, there have been relevant developments that motivate the revision of the current WHO guidance in order to ensure that TB policy makers and medical practitioners in different settings receive the best possible advice and that MDR/RR-TB patients receive treatment in accordance with the latest evidence available and that TB policy makers and other end-users receive updated guidance.

WHO is convening a Guideline Development Group (GDG) meeting from 16 to 20 July 2018 to review the evidence for the treatment of MDR/RR-TB and make recommendations on the composition and duration of suitable treatment regimens. Systematic reviews and other newly emerging evidence will be used as per the WHO requirements for the development of the new policy. The update of the MDR/RR-TB treatment guideline will focus on several topical areas of care for which there is a demand for evidence-based guidance in decision making. These include the use of the shorter MDR-TB regimen; the role of bedaquiline, delamanid, injectable agents and other medicines in treatment regimens for adults and children; the duration of longer MDR-TB regimens and the monitoring of therapeutic response using culture. Advice on how to implement the updated WHO MDR/RR-TB treatment guidelines will also be consolidated in the Companion Handbook to the WHO Guidelines for the Programmatic Management of Drug-Resistant Tuberculosis, a key reference for staff implementing drug-resistant TB care.

In accordance with the WHO policy on the development of evidence-based guidelines, the names, affiliations and brief biographies of experts being considered to participate in the 2018 GDG are being published. Public comment on competing interests for any of the GDG candidates should be sent by 6pm Geneva time on 29 June 2018 (see instructions on how to report in the document below.